Monday, 12 May 2014

Class and minimum unit pricing

I want to preface this post with a caveat that I hope
implicitly precedes every post here: I consider the reasoning and conclusions a
work in progress, and I may be wrong not just in my views or opinions, but in
facts or the logic of interpretation.
Please tell me by comments, email or Twitter if you think that’s the
case here.

I’ve been prompted to write this week by the
print version of a Sheffield article on MUP coming out in the Lancet. (The article was originally published online
in February.) This article looks at how
MUP might affect drinkers from different income brackets, and concludes that
the more you drink the more you are affected, regardless of income bracket –
that is, a high-income harmful drinker will be affected more than a low-income
moderate drinker.

However, consumption being equal (or, rather, consumption
group being equal), it’s estimated that poorer drinkers will be hit harder by
MUP than more affluent ones. (I say hit
harder, but some might say ‘benefit’; that’s where the argument really needs to
be played out, as
I’ve said before.) Obviously, the
lower your income, the richer you are, the less likely you are to buy cheap
alcohol. So a policy that is modelled as
affecting only low-priced alcohol will inevitably affect the poor more than the
rich. (There’s a separate question about
whether only prices below the threshold will actually be affected, but that’s
something for another day, when I’ve done more reading and thinking.)

A key reason for introducing any tax or price control is
that otherwise there would be externalities or other market failures. The stated aim of MUP is to change patterns
of drinking because under current conditions we are understood to consume more
alcohol than is good for us – and possibly others around us.

If the aim is to make alcohol consumption more ‘rational’ then
the fact that MUP would apparently be a targeted intervention implies that
particular groups are more irrational than others, in the sense that
their behaviour needs more of a correction.
Or maybe they’re just easier targets.

Taking such an approach to alcohol consumption would suggest
that those from lower socio-economic backgrounds would be more affected if
they were consuming more to start with.

[This is a slight shift to thinking about what might be
called an outcome (drinking level) rather than levelling a playing field, but
this is what nudging and alcohol policy of almost any kind often assumes: there
is a single right mode and level of consumption (there’s plenty of commentary
on that in my
academic work).]

Those from lower-income groups do consume more lower
priced alcohol, but they don’t particularly consume more alcohol overall
than other groups – as you can see from the charts below. Looking only at ‘harmful’ drinkers, because
those are the ones the policy is supposedly concerned with, we can see that MUP
has the biggest effect on the consumption of the lowest income quintile, which isn’t
actually the highest consuming quintile overall.

I should note that the estimates suggest the policy would be
successful in pulling people’s consumption closer together – which is exactly
the sort of outcome I can imagine being welcomed by some commentators. However, it doesn’t pull down the consumption
of middle-income consumers – who are the biggest consumers overall – by anything
like the lowest quintile.

This isn’t particularly a criticism of the policy in
general, and certainly not of the analysis.
It is, however, a reminder of how this policy would target on the basis
of price, not simply alcohol content or personal level of consumption.

The thought that occurs to me, then, since my mind is filled
with ideas
of liberalism and nudging, is whether such a policy suggests that
low-income consumers are more irrational than middle-income drinkers –
and we’re only talking about harmful drinkers here, remember; those who from a
health perspective should be advised to cut down their consumption.

I’m not sure I’m entirely comfortable with that sort of policy,
which also seems to view cheap alcohol as bad in itself (culturally and
morally).

About Me

I live and work in Dorchester, a beautiful town in Dorset not far from the south coast.
I’m a Senior Health Programme Advisor within the team that commissions drug and alcohol treatment services through Public Health Dorset, which operates across Bournemouth, Poole and rural Dorset.
I'm also a Visiting Fellow in the Faculty of Health and Social Sciences at Bournemouth University.
How did I get here? Well I did a PhD, also at Bournemouth University, looking at ‘binge’ drinking in Bournemouth and thinking about how class and gender are part of how people understand their own and other people’s drinking. (Search on eprints.bournemouth.ac.uk)
After finishing the PhD I moved to London for a couple of years and worked for the Russell Group of universities, dealing most closely with issues of community engagement, widening participation and, unexpectedly, immigration.
When an opportunity came up to head back down to Dorset and work on drug and alcohol issues, I grabbed it with both hands.
I'm on Twitter: @WilliamHaydock